401k Plan data: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS plan

EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF BOONE DRUGS
Plan identification number	501

EMPLOYEE BENEFIT PLAN OF BOONE DRUGS Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Vision Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

BOONE DRUGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: BOONE DRUGS, INC.

Employer identification number (EIN): 560999109

NAIC Classification: 446110
NAIC Description: Pharmacies and Drug Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF BOONE DRUGS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-06-01 COREY FURMAN 2022-09-28
501 2020-06-01 COREY FURMAN 2021-09-12
501 2019-06-01 COREY FURMAN 2020-12-30
501 2018-05-01 COREY FURMAN 2019-10-14
501 2017-05-01
501 2016-05-01
501 2014-05-01 DALE PRESNELL
501 2013-05-01 DALE PRESNELL DALE PRESNELL 2014-11-03
501 2012-05-01 DALE PRESNELL DALE PRESNELL 2013-12-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2021-06-01	COREY FURMAN	2022-09-28
501	2020-06-01	COREY FURMAN	2021-09-12
501	2019-06-01	COREY FURMAN	2020-12-30
501	2018-05-01	COREY FURMAN	2019-10-14
501	2017-05-01
501	2016-05-01
501	2014-05-01	DALE PRESNELL
501	2013-05-01	DALE PRESNELL		DALE PRESNELL	2014-11-03
501	2012-05-01	DALE PRESNELL		DALE PRESNELL	2013-12-16

Plan Statistics for EMPLOYEE BENEFIT PLAN OF BOONE DRUGS

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF BOONE DRUGS

Measure Date Value
2021: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2021 401k membership
Total participants, beginning-of-year 2021-06-01 99
Total number of active participants reported on line 7a of the Form 5500 2021-06-01 92
Total of all active and inactive participants 2021-06-01 92
2020: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2020 401k membership
Total participants, beginning-of-year 2020-06-01 111
Total number of active participants reported on line 7a of the Form 5500 2020-06-01 99
Total of all active and inactive participants 2020-06-01 99
2019: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2019 401k membership
Total participants, beginning-of-year 2019-06-01 124
Total number of active participants reported on line 7a of the Form 5500 2019-06-01 111
Total of all active and inactive participants 2019-06-01 111
2018: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2018 401k membership
Total participants, beginning-of-year 2018-05-01 130
Total number of active participants reported on line 7a of the Form 5500 2018-05-01 124
Total of all active and inactive participants 2018-05-01 124
2017: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2017 401k membership
Total participants, beginning-of-year 2017-05-01 164
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 130
Total of all active and inactive participants 2017-05-01 130
2016: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2016 401k membership
Total participants, beginning-of-year 2016-05-01 167
Total number of active participants reported on line 7a of the Form 5500 2016-05-01 165
Total of all active and inactive participants 2016-05-01 165
2014: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2014 401k membership
Total participants, beginning-of-year 2014-05-01 166
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 167
Total of all active and inactive participants 2014-05-01 167
2013: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2013 401k membership
Total participants, beginning-of-year 2013-05-01 148
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 166
Total of all active and inactive participants 2013-05-01 166
2012: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2012 401k membership
Total participants, beginning-of-year 2012-05-01 98
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 148
Total of all active and inactive participants 2012-05-01 148

Measure	Date	Value
2021: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2021 401k membership
Total participants, beginning-of-year	2021-06-01	99
Total number of active participants reported on line 7a of the Form 5500	2021-06-01	92
Total of all active and inactive participants	2021-06-01	92
2020: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2020 401k membership
Total participants, beginning-of-year	2020-06-01	111
Total number of active participants reported on line 7a of the Form 5500	2020-06-01	99
Total of all active and inactive participants	2020-06-01	99
2019: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2019 401k membership
Total participants, beginning-of-year	2019-06-01	124
Total number of active participants reported on line 7a of the Form 5500	2019-06-01	111
Total of all active and inactive participants	2019-06-01	111
2018: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2018 401k membership
Total participants, beginning-of-year	2018-05-01	130
Total number of active participants reported on line 7a of the Form 5500	2018-05-01	124
Total of all active and inactive participants	2018-05-01	124
2017: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2017 401k membership
Total participants, beginning-of-year	2017-05-01	164
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	130
Total of all active and inactive participants	2017-05-01	130
2016: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2016 401k membership
Total participants, beginning-of-year	2016-05-01	167
Total number of active participants reported on line 7a of the Form 5500	2016-05-01	165
Total of all active and inactive participants	2016-05-01	165
2014: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2014 401k membership
Total participants, beginning-of-year	2014-05-01	166
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	167
Total of all active and inactive participants	2014-05-01	167
2013: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2013 401k membership
Total participants, beginning-of-year	2013-05-01	148
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	166
Total of all active and inactive participants	2013-05-01	166
2012: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2012 401k membership
Total participants, beginning-of-year	2012-05-01	98
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	148
Total of all active and inactive participants	2012-05-01	148

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF BOONE DRUGS

2021: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2021 form 5500 responses
2021-06-01	Type of plan entity	Single employer plan
2021-06-01	Submission has been amended	No
2021-06-01	This submission is the final filing	No
2021-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-06-01	Plan is a collectively bargained plan	No
2021-06-01	Plan funding arrangement – Insurance	Yes
2021-06-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-06-01	Plan benefit arrangement – Insurance	Yes
2021-06-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2020 form 5500 responses
2020-06-01	Type of plan entity	Single employer plan
2020-06-01	Submission has been amended	No
2020-06-01	This submission is the final filing	No
2020-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-06-01	Plan is a collectively bargained plan	No
2020-06-01	Plan funding arrangement – Insurance	Yes
2020-06-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-06-01	Plan benefit arrangement – Insurance	Yes
2020-06-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2019 form 5500 responses
2019-06-01	Type of plan entity	Single employer plan
2019-06-01	Submission has been amended	No
2019-06-01	This submission is the final filing	No
2019-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-06-01	Plan is a collectively bargained plan	No
2019-06-01	Plan funding arrangement – Insurance	Yes
2019-06-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-06-01	Plan benefit arrangement – Insurance	Yes
2019-06-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2018 form 5500 responses
2018-05-01	Type of plan entity	Single employer plan
2018-05-01	Submission has been amended	No
2018-05-01	This submission is the final filing	No
2018-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-05-01	Plan is a collectively bargained plan	No
2018-05-01	Plan funding arrangement – Insurance	Yes
2018-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-05-01	Plan benefit arrangement – Insurance	Yes
2018-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Submission has been amended	No
2017-05-01	This submission is the final filing	No
2017-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-05-01	Plan is a collectively bargained plan	No
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	Submission has been amended	No
2016-05-01	This submission is the final filing	No
2016-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-05-01	Plan is a collectively bargained plan	No
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	No
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EMPLOYEE BENEFIT PLAN OF BOONE DRUGS 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	First time form 5500 has been submitted	Yes
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

427479/427480

Policy instance

Insurance contract or identification number	427479/427480
Number of Individuals Covered	92
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $3,531
Total amount of fees paid to insurance company	USD $469
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $23,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,531
Amount paid for insurance broker fees	469
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )

Policy contract number

0000102149

Policy instance

Insurance contract or identification number	0000102149
Number of Individuals Covered	2
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $46
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

427479/427480

Policy instance

Insurance contract or identification number	427479/427480
Number of Individuals Covered	99
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $4,421
Total amount of fees paid to insurance company	USD $615
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $31,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,421
Amount paid for insurance broker fees	615
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

427479/427480

Policy instance

Insurance contract or identification number	427479/427480
Number of Individuals Covered	111
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $4,403
Total amount of fees paid to insurance company	USD $1,340
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $26,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,403
Amount paid for insurance broker fees	1340
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

511040

Policy instance

Insurance contract or identification number	511040
Number of Individuals Covered	124
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $1,429
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $9,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,429
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

BOONED

Policy instance

Insurance contract or identification number	BOONED
Number of Individuals Covered	130
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00010175498

Policy instance

Insurance contract or identification number	00010175498
Number of Individuals Covered	167
Insurance policy start date	2014-05-01
Insurance policy end date	2015-04-30
Total amount of commissions paid to insurance broker	USD $949
Total amount of fees paid to insurance company	USD $616
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $4,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $949
Amount paid for insurance broker fees	616
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	EBENCONCEPTS COMPANY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00010175498

Policy instance

Insurance contract or identification number	00010175498
Number of Individuals Covered	166
Insurance policy start date	2013-05-01
Insurance policy end date	2014-04-30
Total amount of commissions paid to insurance broker	USD $862
Total amount of fees paid to insurance company	USD $215
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $4,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $862
Amount paid for insurance broker fees	215
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	EBENCONCEPTS COMPANY

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

298446

Policy instance

Insurance contract or identification number	298446
Number of Individuals Covered	148
Insurance policy start date	2012-05-01
Insurance policy end date	2013-04-30
Total amount of commissions paid to insurance broker	USD $803
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $803
Insurance broker organization code?	3
Insurance broker name	EBENCONCEPTS COMPANY

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Company Name:	BOONE DRUGS, INC.
Employer identification number (EIN):	560999109
NAIC Classification:	446110
NAIC Description:	Pharmacies and Drug Stores